Sabuwar Dokar tana ba da izini mai girma daga Dokar Shari'ar
Dokar Kula da Kulawa da kuma dokokin da ta biyo baya sun hada da fadada damar samun damar ɗaukan ciki. Amma mata yanzu suna tunanin ko haɗin inshora don maganin rigakafi zai ɓace, kuma ko za su sami IUD a nan gaba, idan sun dawo don kashewa da yawa daloli.
Kuma bisa ga halaye na dabi'a da ka'idoji na addini waɗanda aka buga a Filato Federal a ranar 6 ga watan Oktoba, akwai shakka akwai damuwa.
Amma sauye-sauyen da aka fuskanta yanzu ya fuskanci kalubale na shari'a kuma yawan adadin ma'aikata da ake tsammani za su yi amfani da su ba su da kyau.
Bari mu dubi Dokar ACA da ta hana ta hana daukar ciki, da tasirin da yake da ita, da kuma abin da za mu iya tsammani zai ci gaba.
Ƙungiyoyi A karkashin ACA
Ɗaya daga cikin abubuwan da ke da rikice-rikice na Dokar Kulawa mai Kulawa (Barack Obama) shine ɗaukar ɗaukar rigakafi. A karkashin ACA, dukkanin tsare-tsaren kiwon lafiyar ba tare da wani kudade ba - dole ne a raba su - ba tare da raba farashi ba - akalla guda ɗaya daga cikin nau'o'in 18 da ke dauke da FDA (wanda aka yarda da shi). da tsare-tsaren shirye-shiryen, bisa ga ka'idojin da aka tsara, mutane miliyan 36.5 da ke da tallafi na aiki-da-gidanka suna kan shirye-shirye, wanda ba a buƙatar bayar da jima'i ba tare da raba farashi ba).
Kodayake da dama daga cikin abubuwan da aka tanadar da ACA bai yi ba har sai shekarar 2014, shirin da aka tsara don kare maganin rigakafi ya kasance tun daga watan Agustan 2012, don duk sabon shirin da sabuntawa.
Domin tsarin da ba a yi ba, wanda aka sake sabuntawa bayan wannan batu, an kara ɗaukar ɗaukar jinya a farkon sabuntawa. Don haka tun watan Agustan 2013, duk wani shirin da ba a yi ba ne, ya ha] a da ha] in gwiwa. An ba da izini ga cibiyoyin addini, amma kuma an fadada shi a shekarar 2014 (sakamakon sakamakon Kotun Koli na Burwell v. Hobby Lobby) don haɗawa da kungiyoyi masu zaman kansu wadanda masu kula da addini suka ƙi bin doka.
Wani bincike na kiwon lafiya na 2015 ya gano cewa yarjejeniyar hana daukar nauyin ACA tana ceton adadin dalar Amurka 255 a kowace shekara, da kuma kimanin $ 248 mai amfani na IUD a kowace shekara (ba tare da dokar hana ta ACA ba, IUDs na yawan kudin $ 500 zuwa $ 1,000. Pre-ACA, wannan za a biya kuɗin gaba, amma an kiyasta tanadi a kan shekara-shekara, yada shekaru fiye da shekaru mace tana da na'urar).
A karkashin ACA, sun tabbatar da cewa matan da ba su da girma ba su biya wani abu a lokacin da suka samu haihuwa, suna zaton sun yi watsi da maganin hana daukar ciki cewa masu asibiti na kiwon lafiya sun rufe su (ACA na buƙatar tsarin kiwon lafiya ya rufe akalla daya daga kowane nau'in, ba ya buƙatar su su rufe kowane nau'i na kowane irin).
Ko da yake ana kiran wannan a matsayin "kyauta" haihuwa, masu soki suna lura cewa babu komai. A gaskiya, farashin maganin hana daukar ciki an nannade cikin kudaden da mata da ma'aikata suka biya don ɗaukar hoto. Saboda haka don kare tsabta, tattaunawa game da kulawar haihuwa ta kyauta a cikin wannan labarin tana nufin batun haihuwa wanda aka ba shi ba tare da wani raba farashi a lokacin da aka samu ba.
Ƙara Hanyar Samun Kasuwanci A Kashe Abortions & Teena Haihuwa
A watan Nuwambar 2016, CDC ta buga bayanai da nuna cewa ta 2013, zubar da zubar da ciki ya kasance a kowane lokaci a cikin Amurka
Ma'aikata masu zubar da ciki sun lura cewa wannan zai iya kasancewa saboda kullin dokokin da aka shige a jihohi daban-daban don rage damar shiga abortions a cikin 'yan shekarun nan. Amma shaida daga Colorado-wanda ba a cikin jihohin da suka wuce dokokin da suka hana yin amfani da abortions-ya nuna cewa samun dama ga masu hana daukar ciki yana taka muhimmiyar rawa: Cibiyar tsara iyali ta Colorado ta fara samar da maganin rigakafi mai dorewa (IUDs da implants) zuwa matasa da mata masu samun kudin shiga a shekara ta 2009, kafin gabatarwar ACA. A shekara ta 2014, haihuwa da zubar da ciki sun ragu da kashi 48 cikin 100.
IUDs da Implants sami nasara A karkashin Dokokin ACA
Har ila yau, CDC ta bayar da rahoton cewa, yin amfani da maganin rigakafi mai mahimmanci na tsawon lokaci (LARC) yana cikin mafi girma a tsakanin matan Amurka.
Wannan shi ne wataƙila saboda haɗuwa da ilimi mafi kyau game da LARC da gaskiyar cewa ACA ta kawar da kariya na iyawa wanda wani lokaci ya hana mata su samu LARC kafin aiwatar da bukatun ACA.
Hanyoyin Sharuɗɗa don Rushewar ACA Ba a yi nasarar ba
Ƙwararrun Jirgin da GOP-sarrafawa Congress ya fara 2017 tare da babban fata na dakatar da ACA, amma wannan bai faru a shekara ta 2017. House Republicans sun wuce Dokar Kula da Lafiya ta Amurka (AHCA) a watan Mayun 2017, amma majalisar ba ta wuce ba duk wani juyi na dokokinsa, kuma ƙarshen shekara ta 30 ga watan Satumba ya kasance ranar ƙarshe don yin amfani da sulhu don ya iya dakatar da ACA tare da kuri'u 50 (da kuri'un kuri'un da aka raba a tsakanin mataimakin shugaban kasa).
Kwamitin Harkokin AHCA da takardun kudade da aka gabatar a Majalisar Dattijan ba zai kawar da dokar ta ACA ba, amma mafi yawansu sun yarda da jihohi su nemi gurɓata don sake sake amfani da muhimmancin kiwon lafiya. Kulawa mai mahimmanci, wanda ya haɗa da maganin hana haihuwa, yana daya daga cikin muhimman abubuwan kiwon lafiyar ACA . Idan an kafa dokoki wanda ya yarda da jihohin da suka samo asarar da suka sake yin amfani da kayan kiwon lafiyar da suka dace, ba za a buƙaci ɗaukar maganin rigakafi ba.
Aikin ACA daban-daban na soke takardun da mutanen Republican suka dauka a shekara ta 2017 zai kuma kawo karshen kudade na tarayya don shirin iyaye na iyali shekara daya, ta rage samun damar yin amfani da ita a tsakanin mata da suka dogara da shirin Planned Parenthood don kulawarsu.
Amma babu wani takardun da suka wuce, kuma Oktoba ya nuna ƙarshen damar da za a iya kafa doka don soke ACA. 'Yan Majalisar Dokokin Republican sun yi alwashin ci gaba da yakin da za a soke dokar, amma Kwamitin Jirgin ya yi aiki don yin canje-canje ta hanyar umarni da sababbin dokoki.
Mene ne a cikin Sabon Dokokin?
A ranar 4 ga watan Mayun shekara ta 2017, 'yan majalisar Republican sun kaddamar da Babban Sakataren Shugaban Hukumar AHCA, wanda ke jagorantar Sakatariyar Wakilan, Labour, da kuma HHS, don " la'akari da bin dokokin da aka tsara, daidai da dokar da ta dace, don magance lamirin- wanda ya sa aka dakatar da shi. Wannan ya kafa mataki don sababbin ka'idoji, wanda, bisa ga New York Times, Ƙarin Trump din yana la'akari a cikin watan Mayu.
A ranar 31 ga watan Mayu, Vox ta samo takardar shaidar HHS da IRS, wanda zai haifar da ƙaddamar da dokar hana daukar ciki ta yanzu. Babu abin da ya faru a cikin 'yan watanni masu zuwa, da kuma mayar da hankali a duk tsawon lokacin rani ne a kan kokarin da majalisar ke yi na soke ACA.
Amma ranar 6 ga watan Oktoba, an wallafa sababbin dokoki guda biyu a cikin Ƙasar Tarayya da ke ba da izini ga ma'aikata su sami damar samun kyauta daga umarnin hana daukar ciki: halayyar dabi'un da halaye na addini .
Dokokin sunyi tasiri nan da nan, ba tare da sanannun sanarwa da lokaci ba. Ana yarda da ra'ayoyin don kwanaki 60 (ta hanyar Disamba 5), amma dokokin sun fara a ranar 6 ga watan Oktoba. HHS yana karɓar maganganun jama'a game da ka'idodin da aka tsara, ya dauke su, kuma ya bayyana yadda yadda jama'a suka tsara tsari na karshe.
Amma a wannan yanayin, suna cewa suna da " kyakkyawan dalili " don aiwatar da ka'idojin nan da nan kuma cewa zai kasance "wanda ba zai yiwu ba kuma ya saba wa jama'a da su jinkirta jinkirta sanya wadannan takardu har sai da cikakken bayani game da sharudda-da-comment An kammala. "A cikin tsaro na yin watsi da sanarwa da kuma lokacin yin sharhi, HHS ya kuma ce ba su buƙatar shiga cikin sharuddan sharudda ba, tun da sun riga sun samu bayanai game da batun yunkurin hana rikici idan aka wallafa dokoki a cikin shekarun baya. Ya kamata a lura da cewa waɗannan sababbin ka'idodin sun kasance sun fi girma fiye da takardun da aka haramta ta HHS, wanda hakan ya yi daidai da wannan.
A karkashin sababbin ka'idoji, kowane ma'aikaci, jami'a, ko mai kula da lafiyar jiki zai iya yin takaddama daga umarnin hana daukar ciki, tare da kowane bangare na addini ko halin kirki a matsayin hujja don fitarwa. Ba dole ba ne ma'aikatan gwamnati-ma'aikata su yarda su ba da izini don su hana maganin rigakafi a tsarin tsarin kiwon lafiyar su kawai don sanar da ma'aikata game da sauye-sauye a amfanin.
Sabuwar dokoki sun bayyana cewa " Ƙara wa'adin ta kawar da matsalolin addini da halin kirki wanda mahalarta da wasu mutane zasu fuskanta waɗanda suke son shiga cikin kasuwancin kiwon lafiyar. " Amma masu bada shawara ga ƙwararrun likita a duniya suna lura cewa tasirin ka'idojin zai zama mata da yawa suna iya samun damar yin amfani da maganin rigakafi, musamman magungunan ƙwaƙwalwar ƙwaƙwalwa (IUDs da implants) mai tsawo wanda ke da matukar haɗin kai idan ba'a rufe su ba.
Lokacin da aka rubuta dokar ta a watan Mayun, ACLU ta yi alkawarin " ga Gidan Kwallon Kotu a Kotun idan suna kokarin bin wannan shirin. " Kuma hakika, ACLU ta yi ta ba da shawara nan da nan a ranar 6 ga Oktoba, kamar yadda Massachusetts Attorney General Maura Healey.
Don bayyanawa, Gwamnatin Obama ta riga ta dauki matakai don tabbatar da cewa ma'aikata ba su da kuɗin biyan kuɗin da za su hana su, amma haɗin kai yana tabbatar da cewa matan da wadanda ke kula da lafiyar masu kula da lafiyar sun ci gaba da samun damar yin amfani da ɗaukar haɗin rigakafi. (wannan ba a koyaushe ake aiwatar da ita ba, duk da haka, wasu mata da masu aiki da addini ba su da damar yin amfani da maganin hana daukar ciki ta hanyar tsarin kiwon lafiya na tallafi). Amma wannan wata mafita ne da wasu masu amfani da addinai suka yi imani suna ci gaba da cin mutuncin 'yancin addini.
Abin da ke faruwa a gaba?
Sabon dokoki sun fuskanci kalubale na gaggawa, kuma ba da daɗewa ba zasu fada idan za su tsaya a kotu. A cikin wata sanarwa game da sharuɗɗa, HHS ya yi iƙirarin cewa sabon dokoki "ba zai shafe fiye da 99.9 cikin dari na mata miliyan 165 a Amurka" saboda suna tsammanin kimanin mutane 200 ne-waɗanda suka riga sun aika hukunci akan dokar hana daukar ciki ta hanyar ƙididdigar addini ko halin kirki-za su kira takaddama a karkashin sabon dokoki.
Amma masu ba da shawara kan mabukaci sun damu da cewa dokokin zasu iya kawo karshen yuwuwa, kuma sabon dokoki suna gabatar da mahimmanci a cikin yarjejeniyar hana daukar ciki.
Yawancin jihohi sun aiwatar da takaddun magance su, amma wadanda kawai ke amfani da tsare-tsaren da aka tsara. Shirye-shiryen kai kanka (wanda shine mafi yawan ma'aikata masu amfani da su) ana tsara su a karkashin tarayya, maimakon jihar, doka. Dokokin ta ACA na amfani da su a fadin hukumar, amma ka'idodi na jihar ba su dace da tsare-tsaren da aka yi ba.
Tsohon Rep. Tom Price (sa'an nan kuma wakilin Republican daga Jojiya, wanda daga bisani ya zama Sakataren HHS na dan lokaci a karkashin Gidan Tayarwa kafin ya yi ritaya a watan Satumba na shekarar 2017) ya ce a cikin shekarar 2012 "mace daya" ba ta iya iya samar da maganin rigakafi kafin Dokar ACA. Amma binciken da aka gudanar a shekara ta 2010 ya shirya cewa kashi 34 cikin dari na mata "sunyi fama da kudin da za'a iya haifar da haihuwa a wani lokaci a rayuwarsu."
A 2012, dalibin lauya na Jami'ar Georgetown, Sandra Fluke, ya shaida a gaban kwamitin kundin tsarin mulki game da ɗaukar rigakafi a karkashin ACA. Ta shaida cewa kashi 40 cikin dari na 'yan makaranta na Jami'ar Georgetown sun ruwaito cewa rashin kulawar kiwon lafiyar jami'a na hana maganin rigakafi ya sa sunyi fama da kudi.
Komawa zuwa cin kuɗi ko rashin asibiti na asibiti don maganin hana daukar ciki bazai iya gabatar da matsala ga mata ba tare da samun kudin shiga wanda ya sanya su a kalla tsakiyar aji. Amma zai iya ba da matsala mai mahimmanci ga mata masu samun kudin shiga. Kuma samun damar yin amfani da ƙwararren ƙwararru mai mahimmanci da ƙwarewa za a iya tasiri sosai idan matakan haɗakar da ke gaban su sun kasance sun cika cikakken asibiti.
> Sources:
> Cibiyar Kula da Cututtuka da Rigakafin Cututtuka, Kula da Zubar da ciki-Amurka, 2013. Nuwamba 25, 2016.
> Cibiyar Kula da Cututtuka da Rigakafin Cututtuka, Cibiyar Nazarin Lafiya ta kasa. Hanyoyi a cikin Amfani da ƙwayar maganin ƙwaƙwalwa mai ƙarfi a cikin Mata tsakanin mata da mata 15-44. Fabrairu 2015 .
> Ma'aikatar Harkokin Kiwon Lafiyar Jama'a ta Colorado da Muhalli, Taron Yarinyar Teen na Colorado ya ci gaba da Farawa. Oktoba 21, 2016.
> Ma'aikatar Lafiya da Ayyukan Dan Adam, Gidajen Lafiya da Gudanarwa na Ayyuka, Ana Ɗaukaka Ayyuka na Gargajiya ta Mata 'Jagora, 2011.
> Rijista Register. Ma'aikatar Baitulmalin; Ma'aikatar Lafiya da Ayyukan Dan Adam. Misalai na Kalmomi da Gidajen Kasuwanci na Wasu Tsare-gyaren Kasuwanci A karkashin Dokar Kulawa da Kulawa . > Oktoba 6, 2017.
> Rijista Register. Ma'aikatar Baitulmalin; Ma'aikatar Lafiya da Ayyukan Dan Adam. Misalan Addini da Harkokin Kasuwanci na Wasu Tsare-tsare Aikin Dokar Kulawa . > Oktoba 6, 2017.
> Lafiya. Mata suna ganin karuwar ƙwaƙwalwar ajiyar kudin da aka kashe ga masu haɗin gwiwa Bayan Dokar ACA ta kawar da Kudin Kudin. Vol 34, Nu 7, Yuli 2015.